By Santy Layno
Ricky Ducas, Jr. was 33 years old when he was diagnosed with Panic Anxiety Disorder (PAD). As a nurse, it was difficult for him to accept this; and though he had to undergo psychotherapy and medication, it took him around a year and six months before he fully embraced his condition.
Looking back, Ricky said he could not believe the symptoms he was feeling at first – e.g. he feared death, and he had no control over what his body wants. His immediate response was to self-diagnose, he said, asking himself: “What could go wrong?”
But then there came a point when he realized that his condition was not just a “simple problem”. He needed a different kind of help; a professional one.
Another problem arose with this recognition/self-acceptance, however.
In the Philippines, he noted, getting professional help for mental health is not easy. “(I) had to wait for three months for an available psychiatrist,” he said, adding that these are the lengths that people with mental illnesses have to go through just to be treated.
Sadly, Ricky is only one of the many cases of Filipinos in need of support to deal with mental health in the Philippines. And though he knows he is fortunate enough to have addressed his condition, “most people do not even know that mental illness is already creeping into their lives,” he said, so that they fail to deal with the same.
LACK OF ATTENTION
The Philippines, actually, has a law – Republic Act no. 11036 or the Mental Health Act of 2018 – focusing on mental health, seeking to establish access to comprehensive and integrated mental health services, while also protecting the rights of people with mental disorders and their family members.
In practice, though, mental health continues to be poorly funded. In 2006, the World Health Organization (WHO) and the Department of Health (DOH) estimated that only 3% to 5% of the total health budget is spent on mental health, with 70% of this spent on hospital care.
This may not be surprising, considering that there continues to be “little epidemiological evidence on mental disorders in the Philippines”. Based on available data (for instance, from the Philippines Statistics Authority in 2010), however, it is known that 14% of the 1.4 million Filipinos with disabilities were identified to have a mental disorder. Now based on figures cited in the 2005 WHO World Health Survey in the Philippines, of 10,075 surveyed Filipinos, 0.4% had a diagnosis of schizophrenia and 14.5% had a diagnosis of depression. Among those diagnosed with schizophrenia, only 33.2% received treatment or screening in the past two weeks, compared with 14% of those with a diagnosis of depression.
In truth, though, the real numbers may actually be higher due to under-reporting, with the DOH claiming in 2005 that only 88 cases of mental health problems were reported for every 100,000 of the population.
BIRTH OF A SUPPORT GROUP
Ricky – who originally wanted to become a doctor until his grandfather passed away, thereby ending the financial support he was receiving for his education – said that there is a slight silver lining.
Unlike before, he said, people can now at least somehow talk about mental disorders openly and without fear, even if there is still stigma surrounding this issue.
In his case in particular, even as a nurse, he wasn’t spared from the misconceptions of people, including those he considered as “friends”. Ricky was – at various points – called crazy and grumpy, and told that it’s all in his mind and that he just wanted to be popular. One time, he recalled, he was told, “You’re already successful, why are you even depressed?”
Then one time, while giving a personality development talk in an elementary school, one Grade 5 student talked to Ricky about ending his life. He was flabbergasted knowing that even at such a young age, the kid already held such thoughts. And for Ricky, it was something that should be addressed thoroughly.
And so he established Anxiety and Depression Support Group – Baguio City, initially as a private Facebook group that became a social marketing/social mobilization endeavor.
Little did Ricky know that this was actually badly needed.
After only a few months, the number of members increased, overwhelming even Ricky. Others stepped up – e.g. his mentors from St. Louis University School of Nursing helped establish the framework now utilized by the group’s admin/moderators/volunteers; and the local government unit (LGU) of Baguio City recognized them, granting them accreditation with the City Youth Development Council to equip them to be able to function professionally.
At this point, Anxiety and Depression Support Group – Baguio City already offers online psychosocial processing and linking clients to psychiatric services; while – to help keep it financially sustainable – conducting fundraising campaigns from selling #ChooseLife merchandise, finding Adapt-a-Family program, and holding the Binnadang Concert for a Cause (at least until the COVID-19 pandemic hit).
That COVID-19 worsened – or at least emphasized the severity of – mental health can’t be stressed enough.
In September 2020, for instance, the National Center for Mental Health revealed an increase in monthly hotline calls regarding depression, with numbers rising from 80 calls pre-lockdown to nearly 400.
It should not have come as a surprise for Ricky to be invited by the City Council of Baguio City together with other mental health advocates, BGHMC Psychiatric Department and private institutions to lay out their mental health programs.
This time around, he wanted to (also) focus on conducting face-to-face debriefing and de-stressing activities for frontliners; a proposal approved by Baguio City’s LGU.
They now have a team helping implement the plans/activities prepared for the City Health Services; as well as work with the help of the Philippine Nurses Association – Cordillera Chapter (which provided nurse volunteers).
There are “small” successes – e.g. “(We) have assisted people and linked them to proper institutions (to deal with their mental health),” Ricky said, adding that this always keeps them going.
Yes, it has not always been smooth sailing.
For instance, “(we) received a letter from one of the national professional organizations questioning our use of the word ‘counseling’ and ‘therapy’ as these words are, supposedly, only to be exclusively used in their profession.” This “monopoly on knowledge” was bewildering for him.
Ricky was also “bashed and bullied online”, where his credibility in handling a support group was questioned.
But Ricky always thought: “What makes it unethical if you are trying to save people’s lives (particularly in) the middle of a pandemic? What makes them think that I may incur more harm than help?”
For him, “I am just an OFW nurse trying to help figure out what things need to be done to be of service.”
Throughout, Ricky also learned important lessons.
First, Ricky learned to choose his battles, and “that not every battle needs to be fought.”
Second, that people need to be compassionate not just to others, but also to themselves. For him, yes, it is okay to be selfish at times; but it’s also “when you are compassionate that you decrease the stress hormones, resulting to calmness.”
And lastly, choose people who will become part of your life well. “Everyone wants to ride in your brand new car, but what I want is someone who will walk with me when my car breaks down,” he said.
PLEA FOR HELP
A lot still needs to be done to deal with mental health in the Philippines.
And yet for Ricky, small steps have been taken already.
He thinks these efforts should be further elaborated – e.g. address this issue in your family, talk about it; and increase funding for it.
More importantly, for Ricky, listen to stories from those who’ve lived through it. “(Let our stories highlight) the importance of acceptance in our lives; acceptance of the condition of others; acceptance of the condition of yourself,” he said. “May this serve as a reminder to break the stigma surrounding mental health discourses.”